In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA). HIPAA addresses several issues related to healthcare. HIPAA protects the confidential handling of your protected health information and makes rules for the electronic transmission of health information. This article summaries and explains your HIPAA rights and how they are applied at Deeds Counseling.
Protected Health Information (PHI) is any record about your physical or mental health created or received by a provider, health plan, employer, or health care clearinghouse that identifies the individual or to which there is a reasonable basis to believe the information can be used to identify the individual.
How HIPAA Allows Your Protected Health Information Shared
There are several ways HIPAA allows providers to share your Protected Health Information (PHI). The following list has the ways HIPAA allows with examples of each use. This list doesn’t cover every possibility. But it explains most of the ways it can be used.
- For your treatment
- To coordinate care with other healthcare professionals
- To provide care with another professional (such as group therapy with 2 therapists)
- Consult with other professionals about the best treatment or hire a consultant to improve your care
- Referring you to other service providers
- Obtaining payment
- Verifying insurance coverage and estimate co-pays, co-insurance and deductibles
- Processing claims and collect fees
- Using a billing agent or accounting professional
- Employing staff for billing and accounting
- Business operations
- Hiring a professional to review of treatment procedures or business activities
- To get certification for treatment interventions or modalities
- To train staff
- Employing staff for administrative tasks (such as scheduling or sending reminders)
- For compliance and licensing activities (such as obtaining a drug and alcohol license)
- Other uses and disclosures without your consent
- Mandatory reporting of child or elder abuse
- Medical emergencies
- Complying with federal or state laws
- Research that helps the community
How Do I Share Your Protected Health Information?
Below I list some ways I am allowed to share your information and some examples of how I might share it. Not all of these will apply to you. And for most of these examples I would get your consent. However, I do not need your consent for the “Without Your Consent” section or for billing purposes.
Many people don’t realize providers can share information to their insurance without a consent. But when you choose to use insurance as payment, you are accepting that information can be shared with your insurance. I may have to share more than your insurance card number too. Your insurance can request your entire chart for auditing. They want to verify you had appropriate treatment.
In Your Treatment:
|I can share it with other health professionals who are treating you.||Example: Sending your doctor a letter that you started or ended therapy.|
|I can coordinate care with your psychiatrist.||Example: Informing your psychiatrist how you are adjusting to medication changes|
|I can share it with another provider to refer you to additional treatment.||Example: A referral for drug and alcohol treatment.|
|I can consult with other professionals to improve the quality of your treatment.||Example: A colleague supervises me and recommends treatment interventions that may help you.|
|I can share it to verify your insurance.||Example: Asking if your insurance covers your treatment and if you have a co-pay, co-insurance or deductible.|
|I can share it to get payment from your insurance.||Example: Completing an insurance claim and calling your insurance about payment.|
|I can share it to staff who help with billing and other administrative tasks.||Example: Hired staff might schedule appointments or help with billing.|
|I can share it to get certifications that show I am competent with certain treatments or theoretical models.||Example: Sharing a summary of your case, treatments used and outcomes to get certified.|
Without Your Consent:
|I will share it if you are a danger to yourself or others.||Example: To the police for involuntary committment if I believe you will hurt yourself and if you threaten to hurt someone else, I have to warn the person.|
|I will share it in a medical emergency.||Example: If you have a medical emergency in my office, I can contact your emergency contact and inform medical personnel of medication you take or other information that can save your life.|
|I will share it when required by law.||Example: If I get a court order or a subpoena and if federal or state laws require it.|
I Will NOT Share Your Protected Health Information:
- For marketing purposes
- To third-parties for profit
- Gossiping to my friends and family
- To your family or friends without consent